How strict does my regimen need to be?

Apr 23, 2009

I am about to begin treatment for the first time. I have ben prescribed Reyataz, Norvir & Truvada. I am not sure what time of the day I want to take my meds. I want to start taking my meds around 10am - but what if I want to switch to later in the day - do I need to gradually adjust the time over several days? How much variability in time is possible without risking developing resistance? My tcells are around 250 and viral load around 20k. Thanks for your help!

Response from Dr. McGowan

Thanks for your question.

I am glad you are focused on taking your meds correctly, that is the main key to successful treatment. The reason that adherence is so important is to maintain the level of medication in the blood above the amount needed to keep the virus suppressed 24 hours a day. Therefore one should always strive not to miss any doses.

Your regimen is a once a day combination. All the medicines are cleared relatively slowly from the blood, so there is a bit of wiggle room, which we call forgiveness, in the exact time of day you need to take it. So, for example, if you are traveling from NY to California, there is a 3 hour time difference..If you take your meds at 7AM in NY you do not have to wake up at 4 to take them in California...you can just make the one time switch to the new time (7 AM California time) then switch back when you return to NY. So if you take your meds (with food is best) at 10AM and want to switch to 1PM (with lunch) you can just make the switch and then stick with the new time. I would avaoid making major switches every day...such as in the morning one day then the next evening (that would give close to 36 hours apart).

Another important thing to remember is that if you forget your dose you should take it as soon as you remember even if it is late...better to be late than to miss it entirely.

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